Two rare cases of human infection with parvum (dwarf) type of Diphyllobothrium latum [syn. D parvum (Stephens,1908)], were discovered in Korea. The first case was a 46-year old houseife, from whom a kind of pseudophyllidean tapeworm eggs was detected in the feces. She was treated with praziquantel and purged, and a complete strobila with scolex, 120 cm in total length, was recovered. She recalled that she had eaten raw trouts at a raw-fish restaurant near the Chungju Lake. Another patient was a 22-year old medical student (male), who used to eat raw sea-foods. He discovered a chain of tapeworm proglottids, 15 cm in length, discharged spontaneously in his stool and brought it for identification. The worms from the two cases were compatible with D. parvum (Stephens, 1908) of which the taxonomic significance has long been questioned. After a detailed morphological study and review of literature, we designated the worms as D. latum parvum type. This is the first report on the occurrence of this rare type of D. latum infection in Korea.
parasitology-helminth-cestoda ; Diphyllobothrium latum parvum type ; sea-food ; human ; case report

BACKGROUND: Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. MATERIAL AND METHOD: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period. RESULT: Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42+/-8.0mm and 42+/-8.3mm left ventricular diastolic dimensions(LVIDd) were 64+/-10.0mm and 56+/-7.4mm left ventricular end systolic volumes(LVESV) were 62+/-19cc (z=1.87+/-0.06) and 59+/-24cc(z=1.78+/-0.08) left ventricular end diastolic volumes(LVEDL) were 169+/-40cc(z-1.17+/-0.1) and 112+/-29cc(z=0.85+/-0.1) and ejection fractions(EF) were 66+/-6.7% and 48+/-12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis (deltaLVEF=-13.3-4.62xLVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. CONCLUSION: Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.
Adult* ; Cardiopulmonary Bypass ; Constriction ; Depression ; Echocardiography ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Ligation ; Male ; Postoperative Period ; Risk Factors ; Ventricular Function, Left

PURPOSE: Gallbladder carcinoma (GBC) is a rare neoplasm with poor prognosis. With the introduction and the wide acceptance of laparoscopic surgery, the diagnostic rate of incidental GBC has increased. We report our experience with the reoperated GBC diagnosed after simple cholecystectomy. METHODS: From March 2001 to July 2005, 17 patients with a postoperative diagnosis of GBC after prior simple cholecystectomy were referred to our center for curative reoperation. The types of simple cholecystectomy were open cholecystectomy in 5 cases, and laparoscopic cholecystectomy in 12 cases. The types of reoperation were hepatic wedge resection with lymph node dissection (HWR /(c) LND, n=9), HWR with LND and bile duct resection (HWR /(c) LND and BDR, n=4), right hepatectomy (RH) with LND and BDR (n=1), extended RH with LND, BDR and caudate lobectomy (n=1) and extended left hepatectomy with LND and BDR (n=1). Residual tumor is defined as the tumor tissue detected on reoperation; bile duct, liver, lymph node, lymphatics, vessels and nerves. RESULTS: There is no operative mortality. The median hospital stay was 18.5days (range, 8 - 44 days). The median interval between 1st and 2nd operation was 23.5 days (range, 6 - 44 days). The median operative time was 379 minutes (range, 240-726). Five complications occurred in 4 patients. One patient received intraoperative transfusion. The depth of tumor invasion in 17 patients was T2 in 15, T3 in 1, and T4 in 1. There was no residual tumor in 8 out of 17 patients. In the other 9 patients, the residual tumor was identified after reoperation; liver in 2, lymph node in 7, bile duct in 3, lymphatics in 6, vessels in 3, and nerves in 3. Three patients of 17 patients recurred and 2 patients of them died. In curative reoperation after simple cholecystectomy, the median follow-up length was 14.7 months (1-53 months). One- and two-year survival rates were 90.9%, 79.6%, respectively. Vascular, lymphatic, and neural invasions were the significant risk factors for recurrence by the log-rank test. CONCLUSION: Reoperation of GBC diagnosed after simple cholecystectomy is safe and may be effective. Lymphatic, vascular, and neural invasion may have a dismal effect on the disease-free survival.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Gallbladder* ; Hepatectomy ; Humans ; Laparoscopy ; Length of Stay ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Neoplasm, Residual ; Operative Time ; Prognosis ; Recurrence ; Reoperation ; Risk Factors ; Survival Rate

BACKGROUND: As the result of renal transplantation improving, also increasing the number of graft failure which will be a candidate for second renal transplantation. The purpose of this study is to evaluate the factors that influence the survival of retransplanted kidney. METHODS: Among 775 renal transplantations that have been performed in Dongsan Medical Center until August 2007, 225 cases were failed their graft function and 59 of them were retransplanted during their follow up period. Graft survival of retransplanted kidney was compared with primary renal transplantation and factors that affecting the survival of kidney retransplantation were evaluated. RESULTS: Main causes of graft failure of first kidney transplantation were chronic rejection, followed by recurrence of original disease of recipient and acute vascular rejection. Mean survival time was 72.6 months (15 days~161 months). One and 5 years graft survivals were 94.6%, 90.7%, and patient survivals were 100.0%, 97.8%, respectively. Among the factors which showed significance in univariate analysis, short interval between failure of first transplantation and retransplantation, and graft failure due to chronic rejection were statistically significant unfavorable factors for survival of retransplanted kidney. CONCLUSIONS: Kidney retransplantation showed similar graft and patient survival compare to the first one. However, retransplantation should be performed after enough time after graft failure and should be cautious in a patient who lost their graft due to chronic rejection.
Follow-Up Studies ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Recurrence ; Rejection (Psychology) ; Survival Rate ; Transplants

Objectives: To evaluate undergraduate medical education in Korea, we aimed at the development of the students' satisfaction questionnaire. Also analysis of the factors affecting student satisfa ction was intended. Subjects: Total students of 33 medical schools in whole country were included as a target population. However, finally 5,452 students from 25 schools participated in the survey. Methods: We developed the questionnaire, asking student satisfaction for six categories of medical education in terms of educational input and process; educator, facility, educational environments. Each school administered questionnaire to their students, and responses with the angle of the distribution of the satisfaction and the factors affecting the satisfaction were analysed by the authors. Results: Overall satisfaction of students was not so high. The older the school, and the larger the students number, the higher the satisfaction level of the students. Students who live in the dormitory were more satisfied with medical education than those live alone. There was no significant correlation between satisfaction level and individual factors of the students such as sex, academic performance level, etc. Conclusion:It is necessary to develop continuous program that evaluate and improve the quality of medical education. Among them measurement in student satisfaction may be one of the useful.
Education, Medical* ; Education, Medical, Undergraduate ; Health Services Needs and Demand ; Humans ; Korea ; Schools, Medical ; Surveys and Questionnaires

A 67-year-old man, diagnosed as hepatocellular carcinoma by percutaneous needle aspiration biopsy of liver mass, presented microangiopathic hemolytic anemia, thrombocytopenia and renal failure from the early phase of the illness. We could establish the diagnosis of cancer-associated hemolytic uremic syndrome which was unrelated to chemotherapy clinically. This is a rare case reported in adult hepatoma patients.
Aged ; Carcinoma, Hepatocellular/*complications ; Case Report ; Hemolytic-Uremic Syndrome/*etiology ; Human ; Liver Neoplasms/*complications ; Male

Cardiac myxoma is the most common primary cardiac tumor, but ventricular myxoma accounts for only 5% of the cases. We report a case of a 62-year-old woman with a left ventricular myxoma emerging from the ventricular side of the mitral valve that led to left ventricular outflow tract obstruction. The patient complained of chest discomfort and dyspnea. A mobile intracardiac mass was seen on echocardiography. The mass was excised and confirmed to be a myxoma by histopathological examination. She was discharged from the hospital without complications and remains asymptomatic.
Dyspnea ; Echocardiography ; Female ; Heart Neoplasms ; Humans ; Middle Aged ; Mitral Valve ; Myxoma ; Thorax ; Ventricular Outflow Obstruction

BACKGROUND AND OBJECTIVES: Regeneration or replacement of damaged hair cells and neurons in the cochlea might be an ideal treatment for sensorineural hearing loss (SNHL). The purpose of the present study was to investigate whether mesenchymal stem cells (MSCs), derived from the bone marrow of rats, could differentiate into auditory hair cells and neurons. MATERIALS AND METHODS: The centrifuge gradient method was used to isolate MSCs from the bone marrow of rats. To confirm whether bone marrow-derived MSCs can differentiate into neuronal cells, culture medium with glial cell-derived neurotrophic factor, brain-derived neurotrophic factor and neurotrophin-3 for 14 days. In addition, immunofluorescence staining and RT-PCR were performed for characterization of the neurospheres and differentiated cells from 7 and 14 day cultures. RESULTS: The results showed that MSCs could differentiate into neuron-positive and hair cell-positive cells, using different compositions of growth factors. And RT-PCR result was identified high or low of gene expression all these differentiated cells. CONCLUSIONS: Rat bone marrow-derived MSCs differentiated into neuronal progenitor cells. These cells might be useful for the treatment of SNHL.
Animals ; Bone Marrow ; Brain-Derived Neurotrophic Factor ; Cochlea ; Ear, Inner ; Fluorescent Antibody Technique ; Gene Expression ; Hair ; Hair Cells, Auditory ; Hearing Loss, Sensorineural ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stromal Cells ; Neurons ; Rats ; Regeneration ; Stem Cells

The diagnosis of cryptosporidiosis has been carried out using coprologic techniques in the Republic of Korea. However, antibody responses to Cryptosporidium have rarely been studied. Serum antibodies from HIV-positive/oocyst-positive Korean patients recognized significantly 31 and 27 kDa antigens, and HIV-negative/oocyst-positive individuals clearly reacted to 15/17 kDa antigens. Compared with oocyst-positive cases, 18.7% and 75.8% of sera from HIV-positive patients reacted to 31 and 27 kDa antigens. Only 11.1% of HIV-negative individuals reacted to 15/17 kDa. Based on these findings, serum antibody responses were different between HIV-positive and HIV-negative individuals infected with Cryptosporidium, and it is suggested that HIV-positive patients are more frequently exposed to C. parvum compared to HIV-negative individuals.
AIDS-Related Opportunistic Infections/blood/*immunology ; Adult ; Aged ; Animals ; Antibodies, Protozoan/*blood/immunology ; *Antibody Formation ; Antigens, Protozoan/chemistry/*immunology ; Blotting, Western/methods ; Cryptosporidiosis/blood/*immunology ; Feces/parasitology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Protozoan Proteins/chemistry/immunology

Leuconostoc species are gram-positive cocci and they are rarely pathogenic in human. Leuconostoc infections are commonly associated with immunocompromised status and indwelling medical devices include intravenous catheter, tracheostomy, endotracheal intubation and percutaneous endoscopic gastrostomy. Clinical isolates of Leuconostoc were frequently misidentified, usually as viridans streptococci, but they possess inherent resistance to vancomycin despite sensitivity to most other antibiotics. We present a case of Leuconostoc peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). A 48-year-old man with hypertensive nephropathy has been treated with peritoneal dialysis, developed peritonitis due to Leuconostoc species. The peritonitis was poorly responded to empirical antibiotics. He was successfully treated with intraperitoneal administration of ampicillin. The dialysis catheter was left in place, and continued to function. To our knowledge, this is the first case of Leuconostoc peritonitis reported in Korea.
Ampicillin ; Anti-Bacterial Agents ; Catheters ; Dialysis ; Gastrostomy ; Gram-Positive Cocci ; Humans ; Intubation, Intratracheal ; Korea ; Leuconostoc* ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tracheostomy ; Vancomycin ; Viridans Streptococci